Abstract Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through evidence-based pricing decisions. Objective: compare the clinical outcome and the costs of two anticoagulants (heparin and (enoxaparin)) used to treat hospitalized patients with COVID-19 infection. Patients and method: The study was a retrospective review of medical records of adult, non-pregnant, COVID-19 infected hospitalized patients who had baseline and last outcome measurements at Alamal Epidemiology Center, Al-Najaf city from (Augast 2020 to June 2021). The outcome measures included D-dimer, length of stay (LOS), and mortality rate. Only the cost of the medical treatment was considered in the analysis. The pharmacoeconomics analysis was done in three different cost-effectiveness analysis methods. Microsoft Excel spreadsheet and Statistical Package for the Social Sciences software (SPSS), was used to conduct statistical analysis. Kaplan Meier test was used to compare the mortality rate. T-TEST was used to compare the outcomes of the two groups. Results and discussion: two groups were compared, the first group consists of 72 patients who received heparin, and the second group consists of 72 patients who received enoxaparin. COVID-19 infected patients had a higher abnormal average D-dimer (2534.675 ng/dl). No significant differences between both genders with regards to the basal average D-dimer (males= 2649.95 ng/dl, females= 2374.1mg/dl, P-value>0.05). There was a significant difference between patient's ages 60 years and patients <60. (3177.33 ng/dl, 1763.06 ng/dl, P-value <0.05). It seems that, higher D-dimer levels were associated with a higher mortality rate (died=3166.263 ng/dl, survived= 1729.94 ng/dl, P-value <0.05). Heparin was more effective in decreasing D-dimer levels than enoxaparin which inversely increased the D-dimer levels (-24.4 ng/dl/day, +154.701 ng/dl/day, P-value <0.05). Additionally, heparin was more effective in increasing the survival rate compared to enoxaparin (55% vs, 35%, P-value<0.05). Heparin was associated with a longer duration of stay in hospital than enoxaparin but with no significant difference (13.7 days, 12.3 days, P-value >0.05). Concerning the cost, treatment with heparin cost less than enoxaparin (2.08 U.S $, 9.44 U.S $)/per patient/per day. Conclusion: Originator heparin was a more cost-effective anticoagulant therapy compared to originator enoxaparin, it was associated with a lower cost and better effect, treatment with Heparin resulted in positive INB= 11.3, where a positive result means that heparin is more cost-effective than Enoxaparin. All three methods of pharmacoeconomic analysis decide that heparin was more cost-effective than enoxaparin in treating COVID-19 infected patients.
In this study four species from Solanaceae family was conducted. These four species belong to four different genera (Solanum L. ? Physalis L. ?Withania Pauq. ? Lycium L.) The study included morphological characters of sex organs and their pollen grains for these Iraqi wild plants.The results showed that the position of epipetalous stamens , the shape of anther, their dimensions ,and the length of filaments are important taxonomical characters .On the others hand the shape of their ovaries and stigmas are also important characters in distinguish between these four species .Pollen grains are similar in their general shapes and polarities, they have three germinal furrows and germinal apertures, so they are minor in distinguish between these f
... Show MoreSocial marketing seeks to develop and integrate marketing concepts with other approaches to social change and aims to influence behaviors that benefit individuals and societies for the social good. The study investigates the type and level of influence of social marketing on customer behavior in tourism companies in Baghdad (Iraq). The sample size of the study is 135 people comprising directors, assistant directors, and marketing staff in tourism companies in Baghdad. A questionnaire was used as a tool to collect data and information, and was prepared by the researcher after it underwent validity, stability, and arbitration tests. The data was analyzed using the statistical program (SPSS v. 25, AMOS v. 23) and statistical methods have been
... Show MoreFinancial markets play an important role in the economy, as it contributes to the financial and economic system of the state stability, as it reduces the adoption of the companies on the loans granted by the banks, as financial markets contribute to attracting and channeling savings to small savers who will be able to buy a number of shares proportional to their savings, It also provides them the place of exchange, and play technology and information systems an important role in facilitating exchanges and increased market activity, in this research touched on the importance of information technology in effect on the activity of the financial markets. Research is divided into three demands of the first concept of eating and the importance
... Show MoreIn Iraq, the domestic goat
The study aimed to identify the effect of the ethical perception of a sample of managers in public organizations on responsible behavior in light of the rapid changes taking place in the external environment. To achieve this, the researcher followed the descriptive analytical approach by applying a questionnaire of two parts. The first part dealt with the ethical perception according to the scale of Johnson (2015), which consisted of (22) items. The second part dealt with measuring responsible behavior, which consisted of (20) items based on the scale of Development of Ethical Behavior (Narvaez, 2006) for a sample of (125) respondents randomly chosen. The results showed that the estimation degree of managers in public governmental o
... Show MoreThe study of Shiranish Formation rocks in southern part of Iraq at Ansab area well (KH-6)
were carried out. The formation is tongued with tayarat formation, which bounded from top
and bottom, the upper tongue at thickness 49m. and tongued at depth (476-525m.) the lower
tongue at thickness 4m. tongued at (541-537m.).
The rocks of this formation were divided into three sedimentary microfacies:
1- Dolomitized formininferal Wackestone facies.
2- Dolomitized formininferal Mudstone facies.
3- Dolostone facies.
34 slides were investigated depending on mineralogical, compositional and biological
processes and compared diagenesis which reflect open marine shelf at lower part of formation
(F.Z.2) (S.M.F.8), but at the
Poverty is defined as a low standard of living in the sense that a poor person can not afford a minimum standard of living. The phenomenon of poverty is one of the most serious problems that must be dealt with seriously. This phenomenon has persisted in Iraq for decades because of the harsh economic conditions and unstable security conditions due to the crises it has faced since 2013. This study requires much study and analysis. And rural areas as a special case. In this study, the researcher examined the poverty line as a criterion in estimating the poverty indicators, which include (poverty percentage H, poverty gap PG, poverty intensity PS), based on the continuous social and economic survey data for households in 2014. The ma
... Show More
The research aims to identify the most important areas of voluntary work available to women in society, stand on the most important controls that push women to work in voluntary areas in society. The research also seeks to stand on the most prominent obstacles to the voluntary work of women in society. The research contained four main chapters: Chapter I: Definition of research, Chapter 2: Objectives, areas, controls and effects of volunteer work, Chapter 3: Voluntary Work of Women in the Celestial Religions, and lastly, Chapter 4: Theories, Constraints, and Recommendations for Voluntary Work for Women.The researcher suggested several recommendations: 1-establishing a unit responsible for planning,
... Show MoreObjective: Evaluation the national standards for exposure to chemical materials and dusts in The State
Company for Drugs Industry in Samarra.
Methodology: A descriptive evaluation design is employed through the present study from 25th May 2011
to 30th November 2011 in order to evaluate the national standards for exposure chemical materials and dusts
in The State Company for Drugs Industry in Samarra. A purposive (non-probability) sample is selected for the
study which includes (110) workers from the State Company for Drugs Industry in Samarra. Data were
gathered through the workers` interviewed according to the nature of work that they perform. The evaluation
questionnaire comprised of three parts which include the w
ABSTRACT
The multi-drug resistant efflux pump is a glycoprotein pump whose function is to push foreign substances. The efflux pump is found in humans, animals. It also has wide-ranging properties in bacteria and fungi. They are found in all species of bacteria, and efflux pump genes can be found in bacterial chromosomes or mobile genetic elements, such as plasmids. The most sensitive function that leads to a global problem is its resistance to antibiotics in bacterial cells, which increases the ability to bacteria from becoming strong virulence factors that most or all antibiotics cannot kill. It also has othe
... Show More